接受化疗的胃肠道癌患者中多种共病症状的独特表现。

Distinct profiles of multiple co-occurring symptoms in patients with gastrointestinal cancers receiving chemotherapy.

机构信息

School of Nursing, Duke University, Durham, NC, USA.

School of Medicine, Duke University, Durham, NC, USA.

出版信息

Support Care Cancer. 2021 Aug;29(8):4461-4471. doi: 10.1007/s00520-020-05946-4. Epub 2021 Jan 16.

Abstract

PURPOSE

Identify subgroups of gastrointestinal (GI) cancer patients with distinct multiple co-occurring symptom profiles and evaluate for differences among these subgroups in demographic and clinical characteristics and quality of life (QOL) outcomes.

METHODS

Patients with GI cancers (n = 399) completed the Memorial Symptom Assessment Scale (MSAS) that was used to assess for multiple co-occurring symptoms. Latent class analysis (LCA) was used to identify subgroups of patients with distinct symptom profiles using symptom occurrence ratings. Differences in demographic and clinical characteristics and QOL outcomes among the subgroups were evaluated using parametric and nonparametric tests.

RESULTS

All Low (36.6%), Moderate (49.4%), and All High (14.0%) classes were identified. Compared to the All Low class, patients in the other two classes were significantly younger and were more likely to report depression and back pain. Compared to the other two classes, patients in the All High class had fewer years of education and a higher number of comorbidities. Significant differences were found among the three classes for comorbidity burden and total number of MSAS symptoms (i.e., All Low < Moderate < All High), as well as for performance status (i.e., All Low > Moderate > All High). A higher symptom burden was associated with poorer QOL outcomes.

CONCLUSIONS

The first study to identify subgroups of patients with GI cancers based on distinct symptom profiles. LCA allowed for the identification of risk factors associated with a higher symptom burden. Clinicians can use this information to identify high-risk patients and develop personalized symptom management interventions.

摘要

目的

确定胃肠道(GI)癌症患者具有不同的多重共病症状特征的亚组,并评估这些亚组在人口统计学和临床特征以及生活质量(QOL)结局方面的差异。

方法

GI 癌症患者(n = 399)完成了纪念症状评估量表(MSAS),用于评估多种共病症状。使用潜在类别分析(LCA),根据症状发生频率评估,识别具有不同症状特征的患者亚组。使用参数和非参数检验评估亚组之间的人口统计学和临床特征以及 QOL 结局的差异。

结果

所有低(36.6%)、中度(49.4%)和所有高(14.0%)类别均被识别。与所有低类别相比,其他两个类别的患者明显更年轻,更有可能报告抑郁和背痛。与其他两个类别相比,所有高类别患者的受教育年限较少,合并症较多。在三个类别中,合并症负担和 MSAS 症状总数(即,所有低<中度<所有高)以及表现状态(即,所有低>中度>所有高)存在显著差异。更高的症状负担与更差的 QOL 结局相关。

结论

这是第一项根据不同症状特征确定 GI 癌症患者亚组的研究。LCA 允许确定与更高症状负担相关的危险因素。临床医生可以使用这些信息来识别高风险患者并制定个性化的症状管理干预措施。

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